Detection of Microhemorrhage in Posterior Reversible Encephalopathy Syndrome Using Susceptibility-Weighted Imaging
Detection of Microhemorrhage in Posterior Reversible Encephalopathy Syndrome Using Susceptibility-Weighted Imaging
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DOI：
10.3174/ajnr.a2886
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发表时间：
2012-05-01
影响因子：
3.5
通讯作者：
Truwit, C. L.
中科院分区：
文献类型：
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作者：
McKinney, A. M.;Sarikaya, B.;Truwit, C. L.
背景和目的：PRES相关的血管源性水肿可能是可逆的，而出血仅发生在15.2%-17.3%的患者中。然而，当考虑SWI时，出血的真实发生率可能更高。因此，我们着手确定MH，SAH和IPH的发病率在PRES通过使用SWI，特别是评估是否这样的MH是reversible.MATERIALS AND METHODS：31例PRES和SWI患者，17后续SWI。两名神经放射科医生审查了SWI、FLAIR、DWI和CE-T1 WI。在就诊和随访时记录SWI、SAH和IPH（> 5 mm）上MH（< 5 mm）的存在和数量。我们评估了SWI和DWI病变，SAH，IPH，对比增强和MR成像severity.RESULTS：出血的存在之间的关联存在于20/31例（64.5%），与MH SWI在18/31（58.1%）在介绍和11/17（64.7%）在后续。SWI显示3/31例SAH，FLAIR显示4/31例SAH，IPH 2/31例。在随访时，没有患者获得新的MH; 1例患者的2/5个MH消退。4例患者在PRES前有可用的SWI，在PRES发作后发展为MH。SWI上MH的存在与DWI、SAH、IPH、增强和MR成像严重程度之间无相关性（均P > 0.05）。结论：SWI显示MH的发生率高于先前描述的，强调了SWI在评估PRES中的潜力。然而，MHS在PRES中的临床相关性尚未确定。我们认为PRES中的MHS与内皮细胞功能障碍有关。
BACKGROUND AND PURPOSE: PRES-related vasogenic edema is potentially reversible while hemorrhage occurs in only 15.2%-17.3% of patients. However, the true incidence of hemorrhage could be higher when SWI is considered. Thus, we set out to determine the incidence of MH, SAH, and IPH in PRES by using SWI and to particularly evaluate whether such MHs are reversible.MATERIALS AND METHODS: Thirty-one patients with PRES and SWI were included, 17 having follow-up SWI. Two neuroradiologists reviewed SWI, FLAIR, DWI, and CE-T1WI. The presence and number of MHs (< 5 mm) on SWI, SAH, and IPH (> 5 mm) were recorded at presentation and follow-up. We evaluated associations between the presence of MH on SWI and DWI lesions, SAH, IPH, contrast enhancement, and MR imaging severity.RESULTS: Hemorrhage was present in 20/31 patients (64.5%), with MHs on SWI in 18/31 (58.1%) at presentation and in 11/17 (64.7%) at follow-up. SAH was present in 3/31 on SWI and 4/31 on FLAIR, while 2/31 had IPH. At follow-up, no patients had acquired new MHs; 2/5 MHs in 1 patient resolved. Four patients with available SWI before PRES developed MHs after PRES onset. No association was found between the presence of MHs on SWI and DWI, SAH, IPH, enhancement, and MR imaging severity (all P > .05).CONCLUSIONS: SWI showed a higher rate of MH than previously described, underscoring the potential of SWI in evaluating PRES. Such MHs typically persist and may develop after PRES onset. However, the clinical relevance of MHs in PRES is yet to be determined. We propose that MHs in PRES relate to endothelial cell dysfunction.